Hammer Toes

A hammer toe is a digit that is contracted at the middle joint of the toe, potentially leading to severe pressure and pain. Ligaments and tendons that have tightened lead to the downward curl of toe.  Hammer toes may occur in any toe including the big toe (hallux). There is often discomfort at the top part of the toe due to rubbing against the shoe.

Initially, hammer toes  can be corrected with simple measures but, if left untreated, they can become fixed and painful and require surgery. Board Certified Podiatric Surgeon David P. Rosenzweig, DPM, PC, can diagnosis and treat your hammer toes successfully at either his Rye Brook (Westchester County) or Greenwich, Connecticut office.

Causes of Hammer Toes Include:

Inappropriate shoes
Flat feet can result in hammer toes
High arched feet can also result in buckling toes
A major cause is in hereditary (family), all the toe conditions mentioned could be acquired due in hereditary factors
Bunions are a major cause of hammer toes
Claw toes are usually the result of poor fitting footwear. For many people, the second toe is actually longer than the great toe (a Morton's Toe). Shoes are sized to fit the great toe, the second (and maybe even the third toe) will have to bend to fit into the shoe. Shoes that are pointed make matters even worse. Combine pointed shoes with high heels; the foot is under similar pressure as if it was constantly being pushed downhill into a wall
Rheumatoid arthritis can also lead to bunions, which in turn can lead to hammer toes

The symptoms of a hammer toe are usually first noticed when a corn develops on the top of the toe and becomes painful, usually when wearing tight shoes.

Non-Surgical Hammer-Toes Treatments

If you have minor discomfort, less severe conditions or are unable to undergo surgery, the symptoms may be treated conservatively (without surgery). This usually involves:

Trimming, padding, or removing corns and calluses
Wearing supportive orthotics (individually fitted plastic or leather inserts) in shoes
Splints or small straps to realign the toe
Wearing shoes with a wider toe box
Anti-inflammatory medications may be injected to relieve pain and inflammation. Medications have proven to be successful in relieving the discomfort associated with bursitis.

* Unfortunately, conservative treatments provide only temporary relief of symptoms - they do not correct the deformity.

Surgical Treatments

When the hammer-toes diagnosis is painful or permanent, surgical correction is recommended to relieve pain, correct the problem and provide a stable, functional toe. Some of the most common surgical procedures are described below.

Surgery may be performed on an outpatient basis at the podiatrist's Rye Brook (Westchester County), New York or Greenwich, Connecticut office. The procedures are usually comfortably performed under local anesthesia or with intravenous sedatives.  You can discuss your options with the doctor.

Tenoplasty and/or Capsulotomy Surgery: this surgery releases or lengthens the tightened tendons and ligaments that have caused the joints to contract. In some flexible hammertoe cases, the toe straightens out after these soft tissue structures are lengthened or cut and relaxed.

Tendon Transfer: treatment for a flexible hammertoe deformity, involves the repositioning of a tendon to straighten the toe.

Bone Arthroplasty:  bone and cartilage is removed to correct the deformity. A small portion of bone is removed at the joint, eliminating pressure on the toe, relieving pain and straightening the digit. The tendons and ligaments surrounding the joint also may be reconstructed. Multiple digits can be operated on simultaneously in certain cases.

Derotation Arthroplasty:  this surgical procedure is a variation of arthroplasty used to realign the toe. A small wedge of skin is removed and the toe is properly positioned. The surgeon also may remove a small amount of bone, and will repair the toe's tendons and ligaments.

Implant Arthroplasty:  is similar to arthroplasty in that a small portion of bone is removed. A silicone rubber or metal implant specially designed for the toe is inserted to replace the gliding surfaces of the joint and to act as a joint spacer. Implant arthroplasty helps maintain toe length while relieving pain, and realigning and stabilizing the joint. Implants may be recommended when previous surgery has left the toe improperlypositioned or without skeletal support.

Fusion of the Toe: is most often used to correct toe fractures or, like implant arthroplasty, to increase the stability of the toe after arthroplasty. After the bone ends are removed, they are positioned together and compressed so that the bones unite.

To make an appointment with the Podiatrist, David P. Rosenzweig, Board Certified in Podiatric Surgery to discuss or treat your hammer toes please contact the Podiatrist at either his Rye Brook (Westchester County), New York or Greenwich, Connecticut office.